University of Illinois Chicago study: One-third of US adults may unknowingly use medications that can cause depression

17 Jun

Moi said in Schools have to deal with depressed and troubled children:
Both the culture and the economy are experiencing turmoil. For some communities, the unsettled environment is a new phenomenon, for other communities, children have been stressed for generations. According to the article, Understanding Depression which was posted at the Kids Health site:

Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds.
As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8. http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

Schools are developing strategies to deal with troubled kids.

Anna M. Phillips wrote the New York Times article, Calming Schools by Focusing on Well-Being of Troubled Students which describes how one New York school is dealing with its troubled children.

Mark Ossenheimer, principal of the Urban Assembly School for Wildlife Conservation in the Bronx, threw out a name to add to the list of teenagers in trouble.
Several teachers and a social worker seated around a table in the school’s cramped administrative offices nodded in agreement. They had watched the student, who had a housebound parent who was seriously ill, sink into heavy depression. Another child seemed to be moving from apartment to apartment, showing up at school only sporadically. And then there was the one grappling with gender-identity issues. Soon the list had a dozen names of students who could shatter a classroom’s composure or a school windowpane in a second.
Convening the meeting was Turnaround for Children, a nonprofit organization that the young-but-faltering school in an impoverished neighborhood near the Bronx Zoo had brought in this year to try to change things.
“This is the condition our organization was created to solve,” said Dr. Pamela Cantor, Turnaround’s founder and president. “A teacher who works in a community like this and thinks that these children can leave their issues at the door and come in and perform is dreaming.”
In focusing on students’ psychological and emotional well-being, in addition to academics, Turnaround occupies a middle ground between the educators and politicians who believe schools should be more like community centers, and the education-reform movement, with its no-excuses mantra. Over the past decade, the movement has argued that schools should concentrate on what high-quality, well-trained teachers can achieve in classrooms, rather than on the sociological challenges beyond their doors. http://www.nytimes.com/2011/11/15/nyregion/calming-schools-through-a-sociological-approach-to-troubled-students.html?hpw

One strategy in helping children to succeed is to recognize and treat depression. https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

Science Daily reported in One-third of US adults may unknowingly use medications that can cause depression:

A new study from University of Illinois at Chicago researchers suggests that more than one-third of U.S. adults may be using prescription medications that have the potential to cause depression or increase the risk of suicide, and that because these medications are common and often have nothing to do with depression, patients and health care providers may be unaware of the risk.
The researchers retrospectively analyzed medication use patterns of more than 26,000 adults from 2005 to 2014, which were collected as part of the National Health and Nutrition Examination Survey. They found that more than 200 commonly used prescription drugs — including hormonal birth control medications, blood pressure and heart medications, proton pump inhibitors, antacids and painkillers — have depression or suicide listed as potential side effects.
Published in the Journal of the American Medical Association, the study is the first to demonstrate that these drugs were often used concurrently and that concurrent use, called polypharmacy, was associated with a greater likelihood of experiencing depression. Approximately 15 percent of adults who simultaneously used three or more of these medications experienced depression while taking the drugs, compared with just 5 percent for those not using any of the drugs, 7 percent for those using one medication and 9 percent for those taking two drugs simultaneously.
The researchers observed similar results for drugs that listed suicide as a potential side effect. These findings persisted when the researchers excluded anyone using psychotropic medications, considered an indicator of underlying depression unrelated to medication use.
“The take away message of this study is that polypharmacy can lead to depressive symptoms and that patients and health care providers need to be aware of the risk of depression that comes with all kinds of common prescription drugs — many of which are also available over the counter,” said lead author Dima Qato, assistant professor of pharmacy systems, outcomes and policy in the UIC College of Pharmacy. “Many may be surprised to learn that their medications, despite having nothing to do with mood or anxiety or any other condition normally associated with depression, can increase their risk of experiencing depressive symptoms, and may lead to a depression diagnosis.”
Qato notes that the study also shows an important trend of increasing polypharmacy for medications with depression, particularly suicidal symptoms, as a potential adverse effect. This makes the need for awareness of depression as a potential side effect even more pressing…. https://www.sciencedaily.com/releases/2018/06/180612185204.htm

Citation:

One-third of US adults may unknowingly use medications that can cause depression
Polypharmacy on the rise
Date: June 12, 2018
Source: University of Illinois at Chicago
Summary:
A new study suggests that more than one-third of U.S. adults may be using prescription medications that have the potential to cause depression or increase the risk of suicide.

Journal Reference:
1. Dima Mazen Qato, Katharine Ozenberger, Mark Olfson. Prevalence of Prescription Medications With Depression as a Potential Adverse Effect Among Adults in the United States. JAMA, 2018; 319 (22): 2289 DOI: 10.1001/jama.2018.6741

Here is the press release from University of Illinois Chicago:

One-third of US adults may unknowingly use medications that can cause depression
June 12, 2018
A new study from University of Illinois at Chicago researchers suggests that more than one-third of U.S. adults may be using prescription medications that have the potential to cause depression or increase the risk of suicide, and that because these medications are common and often have nothing to do with depression, patients and health care providers may be unaware of the risk.
The researchers retrospectively analyzed medication use patterns of more than 26,000 adults from 2005 to 2014, which were collected as part of the National Health and Nutrition Examination Survey. They found that more than 200 commonly used prescription drugs — including hormonal birth control medications, blood pressure and heart medications, proton pump inhibitors, antacids and painkillers — have depression or suicide listed as potential side effects.
Published in the Journal of the American Medical Association, the study is the first to demonstrate that these drugs were often used concurrently and that concurrent use, called polypharmacy, was associated with a greater likelihood of experiencing depression. Approximately 15 percent of adults who simultaneously used three or more of these medications experienced depression while taking the drugs, compared with just 5 percent for those not using any of the drugs, 7 percent for those using one medication and 9 percent for those taking two drugs simultaneously.
The researchers observed similar results for drugs that listed suicide as a potential side effect. These findings persisted when the researchers excluded anyone using psychotropic medications, considered an indicator of underlying depression unrelated to medication use.
“The take away message of this study is that polypharmacy can lead to depressive symptoms and that patients and health care providers need to be aware of the risk of depression that comes with all kinds of common prescription drugs — many of which are also available over the counter,” said lead author Dima Qato, assistant professor of pharmacy systems, outcomes and policy in the UIC College of Pharmacy. “Many may be surprised to learn that their medications, despite having nothing to do with mood or anxiety or any other condition normally associated with depression, can increase their risk of experiencing depressive symptoms, and may lead to a depression diagnosis.”
Qato notes that the study also shows an important trend of increasing polypharmacy for medications with depression, particularly suicidal symptoms, as a potential adverse effect. This makes the need for awareness of depression as a potential side effect even more pressing.
The researchers found use of any prescription medication with a potential depression adverse effect increased from 35 percent in the 2005 to 2006 period to 38 percent in the 2013 to 2014 period. Approximate use of antacids with potential depression adverse effects, like proton pump inhibitors and H2 antagonists, increased from 5 percent to 10 percent in the same period. Use of three or more drugs concurrently increased from 7 percent to 10 percent, approximately.
For prescription drugs with suicide listed as a potential side effect, usage increased from 17 percent to 24 percent, and use of three or more drugs concurrently increased from 2 percent to 3 percent.
“People are not only increasingly using these medicines alone, but are increasingly using them simultaneously, yet very few of these drugs have warning labels, so until we have public or system-level solutions, it is left up to patients and health care professionals to be aware of the risks,” Qato said.
Qato says that solutions worth further study may include updating drug safety software to recognize depression as a potential drug-drug interaction, so that health care professionals, including pharmacists, are more likely to notice if a patient is using multiple medications that may increase risk. Or, including evaluation of medication use in the depression screening and diagnostic tools used by doctors and nurses and recommended by the U.S. Preventive Services Task Force, especially when it comes to persistent or treatment-resistant depression.
“With depression as one of the leading causes of disability and increasing national suicide rates, we need to think innovatively about depression as a public health issue, and this study provides evidence that patterns of medication use should be considered in strategies that seek to eliminate, reduce or minimize the impact of depression in our daily lives,” Qato said.
Co-authors on the study are Katharine Ozenberger of UIC and Columbia University’s Mark Olfson. Qato and Olfson both noted financial disclosures potentially relevant to the study.
Contact
Jacqueline Carey
312-996-8277
jmcarey@uic.edu
twitter.com/JCareyUIC

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Schools have to deal with depressed and troubled children
https://drwilda.wordpress.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

School psychologists are needed to treat troubled children
https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’
https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

Resources:
1. About.Com’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

2. Psych Central’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

3. Psychiatric News’ Study Helps Pinpoint Children With Depression http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

4. Family Doctor’s What Is Depression? http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

5. WebMD’s Depression In Children http://www.webmd.com/depression/guide/depression-children

6. Healthline’s Is Your Child Depressed?
http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

7. Medicine.Net’s Depression In Children http://www.onhealth.com/depression_in_children/article.htm

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